1. Impaired calcium absorption
After gastrectomy, people usually can’t get enough calcium from food, and then the bone will become very weak, which we call osteochondrosis. Patients can supplement vitamin D and calcium under the guidance of doctors.
2.Anemia caused by iron and vitamin B12 deficiency
Anemia is the inability of the blood to carry enough oxygen. Among them, iron deficiency anemia is the most common. Hemoglobin carries oxygen, and iron is the main component of hemoglobin. If not enough iron is consumed or absorbed, iron deficiency anemia will easily occur. The main causes of iron deficiency are: the conversion of iron in food into absorbable iron needs to be done by gastric juice, which is reduced after gastric surgery; the passage of food from the small intestine too quickly reduces the time for iron absorption; and if the small intestine is rerouted during surgery, the area of the small intestine is reduced and iron absorption is reduced. Iron deficiency anemia can be corrected by iron supplementation.
In addition, deficiency of vitamin B12, another raw material that makes up red blood cells, can also lead to anemia. After total or partial gastrectomy, the absorption of vitamin B12 is affected by the reduction of endogenous factors secreted by the stomach. Intravenous injection of vitamin B12 is able to replenish the deficient vitamin B12. monthly injection of vitamin B12 is needed to determine the presence of vitamin B12 deficiency if a total gastrectomy is received, or regular testing if a partial gastrectomy is performed.
3.Difficulty in swallowing due to anastomotic stricture
After total gastrectomy, the lower part of the esophagus and the upper part of the jejunum are connected to form an anastomosis, and sometimes there is a narrowing of the anastomosis and difficulty in passing food, which we call anastomotic stenosis. If you feel difficulty in swallowing food, it is recommended that the patient should consult a doctor and have a gastroscopy as soon as possible. If anastomotic stenosis is found, the doctor will dilate the stenosis or place a stent under gastroscopy to help smooth feeding.
4. Psychological problems
Many patients suffer from complications after surgery, some feel pessimistic because they cannot feel pleasure from eating, and others have difficulty adjusting to the changes in appearance after surgery. However, as long as the patient perseveres, he or she will find that after a period of time, although the eating problems do not all disappear, he or she will be able to adapt and deal with them well. This also requires the support of family and professional care. If the above-mentioned psychological problems occur, you need to go to the hospital as soon as possible and have professional guidance from a specialist.
5.Dietary advice
The dietary advice after gastric cancer surgery varies according to the type of surgery, surgery site and individual situation. Generally speaking, post-surgical dietary recovery of gastric cancer needs to go through 4 stages, and the duration of each stage, the body’s recovery and the speed of adaptation to food are related. Usually, you can eat normally after 3 months of surgery.
Stage 1: Liquid food
The first two days after surgery are fasting, and after exhaustion, you can eat liquid food, including broth, unsweetened juice and milk. It is not recommended to drink carbonated drinks and caffeinated drinks, and it is better to drink water half an hour after eating.
Stage 2: Paste food
Once the patient can adapt to a liquid diet, it is time to try ground paste foods. During this 2 to 4 week period, it is best to eat foods that do not contain solid ingredients. First the patient needs to choose appropriate foods such as: lean meats, beans, fish, egg whites, yogurt, soft fruits and vegetables, and nonfat cheese. Next mix the above solid foods with the following liquids: water, skim milk, unsweetened fruit juices, broth. At this point the patient’s digestive system is sensitive to spicy foods and dairy products, so if these foods are highly preferred, they can be gradually added to the diet.
Stage 3: Soft food
After a few weeks, the patient can enter the soft food stage, which requires the use of a spoon to mash foods so that they are soft, such as cooked meat, soft or canned fruits, and cooked vegetables. This stage lasts for about 8 weeks, after which it can be spent to solid food.
Stage 4: Solid foods
This stage is almost close to a normal diet and the patient may still find it very difficult to eat spicy foods and crunchy foods. The following foods are not recommended, such as nuts, dried fruits, popcorn, carbonated beverages such as soda, coarse fiber vegetables including celery, broccoli, corn, and cabbage, and strong tough meats and meats with cartilage. These foods are usually not well digested and can cause gastrointestinal discomfort. After a further period of time patients may consider trying the above foods.
In each of these stages, in order to ensure balanced nutrition and adequate energy intake, patients need to eat small and frequent meals, take enough vitamins and minerals, drink water between meals, slow down both eating and drinking, chew food well, try only one new food at a time, consume more high-protein foods, avoid high-fat and high-sugar foods, etc.